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Archives of Orthopaedic and Trauma Surgery

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Open Access 01-06-2016 | Orthopaedic Surgery

International survey and surgeon’s preferences in diagnostic work-up towards treatment of anterior shoulder instability

Authors: Hanneke Weel, Wouter Tromp, Peter R. Krekel, Pietro Randelli, Michel P. J. van den Bekerom, Derek F. P. van Deurzen

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 6/2016

Abstract

Purpose

Recurrent anterior shoulder instability after surgical treatment can be caused by bony defects. Several diagnostic tools have been designed to measure the extent of these bony lesions. Currently, there is no consensus which measurement tool to use and decide which type of surgery is most appropriate. We therefore performed an evaluation of agreement in surgeons’ preference of diagnostic work-up and surgical treatment of anterior shoulder instability.

Methods

An international survey was conducted amongst orthopaedic shoulder surgeons. The survey contained questions about surgeons’ experience, clinical and radiological examination and the subsequent treatment for anterior shoulder instability. Descriptive statistics were used to present the data, and percentages of responding surgeons were calculated.

Results

The questionnaire was completed by 197 delegates from 46 countries. 55 % of the respondents think evidence in current literature is sufficient on diagnostic work-up for anterior shoulder instability. Anamnestic, number of dislocations was most frequently asked (by 95 % of respondents), the most frequently used test is the apprehension test (91 %). For imaging, conventional X-ray in various directions was most performed, followed by MR arthrography and plane CT scan respectively. The responding surgeons perform surgery (labrum repair or Latarjet) in 51 % of the patients. A median of 25 % glenoid bone loss was given by the respondents, as cut-off from when to perform a bony repair.

Conclusion

Many different diagnostic examinations for assessing shoulder instability are used and a high variety is seen in the use of diagnostic tools. Also no consensus is seen in the use of different surgical options (arthroscopic and open procedures). This implies the need for more research on diagnostic imaging and the correlation with specific subsequent surgical treatment.

Level of evidence

Survey, level of evidence IV.

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Title: International survey and surgeon’s preferences in diagnostic work-up towards treatment of anterior shoulder instability
Authors: Hanneke Weel
Wouter Tromp
Peter R. Krekel
Pietro Randelli
Michel P. J. van den Bekerom
Derek F. P. van Deurzen
Publication date: 01-06-2016
Publisher: Springer Berlin Heidelberg
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 6/2016
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-016-2443-7

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Springer Medicine

International survey and surgeon’s preferences in diagnostic work-up towards treatment of anterior shoulder instability

Abstract

Purpose

Methods

Results

Conclusion

Level of evidence

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Level of evidence

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